A Retrospective Analysis of Isoniazid-Monoresistant Tuberculosis: Among Iranian Pulmonary Tuberculosis Patients



Mohammad Varahram, Mohammad Javad Nasiri*, Parissa Farnia, Mohadese Mozafari , Ali Akbar Velayati
Mycobacteriology Research Centre, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran


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© Varahram et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Mycobacteriology Research Centre, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Tel: +98 21 27122259; Fax: +98 21 26109505; E-mail: mj.nasiri@sbmu.ac.ir


Abstract

Background and objectives:

Isoniazid (INH) is one of the most potent anti-tuberculosis (TB) drugs. The spread and transmission of INH- resistant bacilli are likely to pose a significant problem for National TB control Program (NTP). In this study, we aimed to determine the trend of INH-monoresistant TB in Iran.

Methods:

The susceptibility patterns of Mycobacterium tuberculosis (MTB) strains that were isolated from clinical samples were retrospectively analyzed (January 2003-December 2011). Identification and drug susceptibility testing (DST) were performed using both conventional and molecular methods. The associated risk factors were assessed using the Chi-square test.

Results:

Out of 4825 culture-positive isolates, 6.1% were resistant to INH, with an increasing trend over the study period. The INH-monoresistance from 4.4 in 2003 reached to 9.4% in 2011. Among the studied risk factors, age was significantly associated with INH-monoresistance (p < 0.05).

Conclusions:

The increased trend in INH-monoresistance underlines the need for greater enforcement of national TB control programs. In this regard, better management of TB cases, establishing advanced diagnostic facilities and use of standard treatment regimens are recommended to avoid further emergence of INH resistant cases.

Keywords: Drug resistance, isoniazid, Iran, Mycobacterium tuberculosis..